CLEARFIELD - Davis County has less of a need for either of Utah’s proposed Medicaid expansion plans than the rest of the state.

According to Lewis Garrett, director of the Davis County Health Department, the county has a “very high” rate of residents who already have health insurance coverage. Whether the legislature chooses to go with Governor Gary Herbert’s federally-funded privatization plan or Speaker Becky Lockhart’s smaller state-funded plan, it won’t change the county’s percentages a great deal.

“We’re lucky in that regard,” said Garrett. “The number of residents who would be covered by the expansion is smaller than other places around the nation, and even in the state.”

One way that local residents will feel the effects, however, is financially. Some of that will be in savings; a trickle-down effect of the fact that clinics and emergency rooms will have fewer non-insured patients that they will eventually have to write off.

“When people get sick, they go to the hospital whether or not they have insurance,” said Garrett. “That’s very expensive, and right now it’s cost-shared with everyone.”

The costs may crop up elsewhere, though. Herbert’s plan is essentially a privatized version of the Affordable Care Act, with Utahns earning less than $15,500 a year would pay up to 2 percent of their incomes for insurance. The cost for the first year of the program is estimated at $258 million, and a pilot version would run for three years.

Herbert plans to fund the program through a block grant the state would request from the federal government, an alternative to the money that would be returned to the state if Utah had chosen to participate fully in the Affordable Care Act. Discussions with the government about whether they would offer such a grant haven’t yet begun, though Arkansas and Iowa have received waivers for their own alterations to the plan.

Even if the government says agrees to Herbert’s idea, Garrett pointed out that full re-imbursement won’t be permanent. For those states under the full version of the Affordable Care Act, federal coverage will drop to 90 percent of the total cost by 2020.

“The federal government is paying for 100 percent of the Medicaid expansion now, but only for a period of time,” said Garrett. “A few years out, it will become a cost share situation between them and the states.”

House Speaker Becky Lockhart, R-Provo, has spoken out against the governor’s plan. She’s advocating a much smaller $35 million dollar option that would cover a smaller number of people and be entirely funded by the state.

“We’d like to see as many people as possible get coverage,” said Garrett. “It all depends on budget constraints.

The Utah Legislature is expected to reach a decision by March 13, when the 2014 session ends. Whatever the final decision is, Garrett would like to see local residents to do what they can to make themselves less reliant on insurance in the first place.

“Most of the health issues in Davis County, Utah and across the country are chronic diseases related to lifestyle issues,” he said, listing problems such as smoking and obesity. “If people take care of these issues on the front end, they’re less likely to have problems down the road.”